Revised Mediclaim Policy To Also Cover Abortion

The revision in mediclaim insurance now covers "voluntary medical termination of pregnancy". Since January 1, the four state-owned general insurance companies have also revised the premiums for mediclaim cover upwards by 15 to 30 per cent across various age slabs, in keeping with the mounting claim ratios.

The rise in premium for mediclaim cover varies depending upon the age of the insured, as claims ratios have been higher in the upper age bracket (45 years and above). The revision in premium has been maximum in this age bracket at 30 per cent. The four state-owned insurers have also introduced a new age slab of zero to 35 years where the rise in the premium is 15 per cent. The age bracket of 35 to 45 years has seen premium rise by 25 per cent. In the age slabs of 46 years and above, the increase in the premium is to the tune of 30 per cent.

On group medical policies, the state-owned entities have decided to load an additional 25 per cent charge on renewal of these group covers where the claim ratios stand at 70 to 100 per cent. In many instances, loss claim ratios are above 100 per cent, and the state companies will thus take a call on whether or not to renew these group covers, said insurance officials.

New India Assurance Company chairman K N Bhandari stated the need for the rise in premium rates following the increase in the cost of medical treatment.

The revised mediclaim policy now covers expenses relating to MTP in the first 12 weeks of conception. It continues to exclude expenses related to pregnancy or childbirth. The cover also excludes dental treatment, intentional self injury as well as any pre-existing diseases. It also excludes treatment for cataract, benign prostatic hypertrophy, hysterectomy for menorrhagia or fibromyoma, hernia, hydrocele, congenital internal diseases, fistula in anus, piles, sinusitis and related disorders in the first year of taking the policy.

Mediclaim insurance covers expenses on hospitalisation for a minimum period of 24 hours. This time limit factor is not applicable in the case of treatments such as dialysis, chemotherapy, lithoripsy, radiotherapy, eye surgery, dental surgery, tonsillectomy, D&C taken in hospital/nursing homes.